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The “syncope and dementia” study: a prospective, observational, multicenter study of elderly patients with dementia and episodes of “suspected” transient loss of consciousness

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Abstract

Background and aim

Syncope and related falls are one of the main causes and the predominant cause of hospitalization in elderly patients with dementia. However, the diagnostic protocol for syncope is difficult to apply to patients with dementia. Thus, we developed a “simplified” protocol to be used in a prospective, observational, and multicenter study in elderly patients with dementia and transient loss of consciousness suspected for syncope or unexplained falls. Here, we describe the protocol, its feasibility and the characteristics of the patients enrolled in the study.

Methods

Patients aged ≥65 years with a diagnosis of dementia and one or more episodes of transient loss of consciousness during the previous 3 months, subsequently referred to a Geriatric Department in different regions of Italy, from February 2012 to May 2014, were enrolled. A simplified protocol was applied in all patients. Selected patients underwent a second-level evaluation.

Results

Three hundred and three patients were enrolled; 52.6 % presented with episodes suspected to be syncope, 44.5 % for unexplained fall and 2.9 % both. Vascular dementia had been previously diagnosed in 53.6 % of participants, Alzheimer’s disease in 23.5 % and mixed forms in 12.6 %. Patients presented with high comorbidity (CIRS score = 3.6 ± 2), severe functional impairment, (BADL lost = 3 ± 2), and polypharmacy (6 ± 3 drugs).

Conclusion

Elderly patients with dementia enrolled for suspected syncope and unexplained falls have high comorbidity and disability. The clinical presentation is often atypical and the presence of unexplained falls is particularly frequent.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study or, in the case of severe cognitive impairment, from their relatives.

Author information

Authors and Affiliations

  1. Syncope Unit, Geriatric Cardiology and Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Viale Pieraccini 6, 50139, Florence, Italy

    Andrea Ungar & Alice Ceccofiglio

  2. Centro di Valutazione e Ricerca Gerontologica, Chair of Geriatrics, University of Modena and Reggio Emilia, Modena, Italy

    Chiara Mussi & Giulia Ghidoni

  3. Medicine and Geriatric Unit, Spedali Civili of Brescia, Brescia, Italy

    Franco Nicosia

  4. Acute Geriatric Unit, Department of Health Sciences, San Gerardo Hospital, University of Milano Bicocca, Monza, Italy

    Giuseppe Bellelli

  5. Milan Center for Neuroscience (Neuro-Mi), Milan, Italy

    Giuseppe Bellelli

  6. SCDU Geriatria e Malattie Metaboliche dell’Osso, Città della Salute e della Scienza-Molinette-Torino, Turin, Italy

    Mario Bo

  7. Geriatric Department, SS. Trinità Hospital, Cagliari, Italy

    Daniela Riccio

  8. Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy

    Francesco Landi & Anna Maria Martone

  9. Division of Geriatrics, Ospedale “S. Maria di Ca’ Foncello”, Treviso, Italy

    Assunta Langellotto

  10. Geriatric Unit, Santa Chiara Hospital, Trento, Italy

    Gabriele Noro

  11. Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy

    Pasquale Abete

Authors
  1. Andrea Ungar
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  2. Chiara Mussi
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  3. Franco Nicosia
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  4. Alice Ceccofiglio
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  5. Giuseppe Bellelli
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  6. Mario Bo
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  7. Daniela Riccio
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  8. Francesco Landi
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  9. Anna Maria Martone
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  10. Assunta Langellotto
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  11. Giulia Ghidoni
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  12. Gabriele Noro
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  13. Pasquale Abete
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Corresponding author

Correspondence to Andrea Ungar.

Appendix

Appendix

Centres and participants: Dr. Enrico Mossello, Dr. Martina Rafanelli, Dr. Francesca Tesi, Dr. Giulia Bulli and Dr. Duccio Romagnolo (Syncope Unit, Geriatric Cardiology and Medicine. University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy); Dr. Diana Bertoni (Medicine and Geriatric Unit, Spedali Civili of Brescia, Italy); Dr. Susanna Motta and Dr. Sara Zazzetta (Department of Health Sciences, University of Milano Bicocca; Acute Geriatric Unit, San Gerardo Hospital, Monza, Italy; Milan Center for Neuroscience, Milan, Italy); Dr. Michela Tibaldi (SCDU Geriatria e Malattie Metaboliche dell’Osso, Città della Salute e della Scienza-Molinette-Torino, Italy); Dr. Barbara Orani (Geriatric Department, SS. Trinità Hospital, Cagliari, Italy); Dr. Gianni Tava (Geriatric Unit Santa Chiara Hospital, Trento, Italy); Dr. Livia Guadagno (Department of Translational Medical Sciences, University of Naples Federico II, Italy).

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Ungar, A., Mussi, C., Nicosia, F. et al. The “syncope and dementia” study: a prospective, observational, multicenter study of elderly patients with dementia and episodes of “suspected” transient loss of consciousness. Aging Clin Exp Res 27, 877–882 (2015). https://doi.org/10.1007/s40520-015-0354-z

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  • DOI: https://doi.org/10.1007/s40520-015-0354-z

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